This application seeks five years of support to allow R. Lawrence Moss, MD, to make major contributions to the level of Children's Surgery by achieving his career objectives in patient-oriented clinical research. His foremost professional objective is to introduce scientific rigor and established clinical research techniques into the manner in which surgical treatments in children are evaluated. Dr. Moss is an active clinical Pediatric Surgeon and an internationally recognized and established clinical investigator. He is the principal investigator for the first ever multi-center clinical trial in Children's Surgery ROl HD 38462. He serves as Stanford Site Director and only surgeon of the first multi-disciplinary patient-oriented research network in Pediatrics. He holds multiple national leadership positions in Pediatric Surgery, and is recognized as a leader in clinical research in the field. He has mentored twelve postdoctoral fellows in clinical research of whom the past five have each obtained extramural funding based on their outstanding productivity. Stanford University is an exceptionally rich environment for patient-oriented research, and has identified clinical investigation as a major focus of the Medical School for the next decade. Dr. Moss' work is an integral component of this institutional mission in clinical research. Examples of work to be conducted during the training period include; 1) leading a twelve-center trial of peritoneal drainage versus laparotomy for infants with perforated necrotizing enterocolitis; 2) establishment of the first multi-center neonatal surgical database for children with congenital anomalies; and 3) development of a multi-institutional consortium to study biliary atresia. With the support of this award, the awardee's underlying objectives are three-fold: 1) to make substantive contributions to the field Children' s Surgery that will directly impact the health and well-being of children; 2) to conduct multiple clinical research projects that change the shape of the discipline of academic Pediatric Surgery; and 3) to mentor the next generation of physician scientists in Children's Surgery to be critical thinkers who are well versed in clinical research techniques.